Testicular Trauma: Symptoms, Recovery, and When to Seek Help

Testicular issues

Hello Doctor: At the beginning of December, I was struck on my left testicle (it was a strong hit from a hand).
After going to the hospital for an examination, the doctor performed a physical examination and visual inspection, stating that there was no major issue and no bleeding.
The doctor mentioned that externally it appeared normal, and that an ultrasound would yield the same results, so I was not given an ultrasound.
I was told it would heal in three to five days.
Now, nearly three weeks have passed; although there has been some improvement, I still experience discomfort, especially when walking quickly or during car rides, which causes a sharp pain.
Sitting upright in a chair also creates an uncomfortable pressure on the left testicle, and I feel that the left testicle is positioned significantly more forward than the right (more noticeable than before the injury).
I would like to ask the doctor: 1.
Is it possible for a testicle to be injured with no external symptoms but have internal damage or bleeding? 2.
Is it possible for a testicle to take this long to heal without any obvious external trauma? 3.
Under what circumstances can testicular atrophy occur after trauma? I am worried about the possibility of an unseen blood clot leading to ischemic atrophy of the testicle.
4.
Should I return for further examination in this situation? I have many questions, and I appreciate your response, thank you, Doctor.

Wu, 20~29 year old female. Ask Date: 2020/12/20

Dr. Xu Wencang reply Urology

Injuries typically result in bruising.
If pain persists, an ultrasound evaluation may be performed.

Reply Date: 2020/12/20

More Info

Testicular trauma can be a concerning issue, especially when it involves a significant impact, as you've described. Let's address your questions one by one, while also providing some context about the symptoms, recovery, and when to seek further medical help.

1. Can testicular trauma cause internal damage or bleeding even if there are no external symptoms?
Yes, it is possible for testicular trauma to result in internal injuries that are not immediately visible. The testicles are surrounded by a protective layer called the tunica albuginea, and while this layer can absorb some impact, severe trauma can lead to conditions such as testicular rupture or hematoma (a collection of blood outside of blood vessels). These injuries may not present with external signs but can still cause significant discomfort and complications. If you are experiencing ongoing discomfort, it may be worth investigating further.

2. Is it normal for testicular trauma to take a long time to heal without visible signs of injury?
Recovery from testicular trauma can vary widely among individuals. While some may heal quickly, others may experience lingering discomfort for weeks or even months. Factors such as the severity of the impact, individual pain tolerance, and any underlying conditions can influence recovery time. The fact that you are still experiencing discomfort after three weeks suggests that there may be some residual effects from the trauma, which could warrant further evaluation.

3. Under what circumstances might testicular atrophy occur following trauma?
Testicular atrophy can occur if there is a significant injury that leads to compromised blood flow to the testicle. This can happen due to a hematoma or other internal injuries that disrupt the blood supply. If the testicle does not receive adequate blood flow, it can begin to shrink and lose function. Symptoms of atrophy may include a noticeable change in size, pain, or discomfort. If you are concerned about the possibility of internal bleeding or atrophy, it is essential to seek medical advice.

4. Should I return for further examination?
Given your ongoing symptoms, it would be prudent to return to your healthcare provider for further evaluation. While the initial assessment may not have indicated any serious issues, persistent pain, changes in the position of the testicle, and discomfort during movement are all signs that should be taken seriously. A follow-up examination, possibly including an ultrasound, can help rule out any complications such as a hematoma or other internal injuries that may not have been apparent during the initial assessment.

In summary, while some discomfort following testicular trauma can be normal, persistent symptoms warrant further investigation. It is essential to communicate openly with your healthcare provider about your concerns and symptoms. They may recommend imaging studies or other diagnostic tests to ensure that there are no underlying issues that need to be addressed. Remember, early intervention can often prevent more significant complications down the line.

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